A “Bloody” Tradition

“I just wept, and called out to my mother for help. But the worst shock of all was when I looked around and found her standing by my side. Yes. It was her, I wasn’t mistaken. In flesh and blood, right in the midst of these strangers, talking to them and smiling at them as though they had not participated in slaughtering her daughter just a few minutes ago. Now we know where the tragedy lies. We are born of a special sex, the female sex. ” These are the words of El-Salami, one of the 3 million girls who fall victim to “Female Genital Mutilation” every year.

Violence against women and girls is one of the most widespread violations of human rights. It can include physical, sexual, psychological and economic abuse, and it cuts across boundaries of age, race, culture, wealth and geography. Female Genital Mutilation (FGM) or Circumcision is an extreme case of all these violations, where the suffering lasts a life-time. Often performed without anesthetic under septic/aseptic conditions by lay practitioners with little or no knowledge of human anatomy or medicine, female circumcision can cause death or permanent health problems as well as severe pain. Despite these grave risks, its practitioners look on it as an integral part of their cultural and ethnic identity, and some perceive it as a religious obligation. Between 100 million and 140 million women, mostly in 28 African and Middle Eastern countries, and others living as immigrants in Australia, Canada, Europe, New Zealand and the USA have experienced genital mutilation. This ancient practice contrary to popular belief is not encouraged by any religion. A recent lunch time discussion on migration and health came as a surprise to me. It is evident that not many individuals living outside this tradition are aware of its consequences.

Female Circumcision is a matter of universal concern. FGM is done by partial or total removal of the clitoris, partial or total removal of the clitoris and the labia minora (the lips that surround the vagina), and narrowing of the vaginal opening through the creation of a covering seal. They form the seal by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris. This leaves an opening that may be as small as a matchstick for the passage of urine and menstrual blood. This apathetic mutilation of female genitalia has severe consequences. Even the less extensive types of genital cutting can lead to potentially fatal complications, such as hemorrhage, infection and shock. The inability to pass urine because of pain, swelling and inflammation following the operation may lead to urinary tract infection. A woman may suffer from abscesses and pain from damaged nerve endings long after the initial wound has healed.

Infibulation or sealing off vaginal opening is particularly likely to cause long-term health problems. Because the urethral opening is covered, repeated urinary tract infections are common, and stones may form in the urethra and bladder because of obstruction and infection. Without deinfibulation before childbirth, obstructed labor may occur, causing life-threatening complications for both mother and infant, and hence a woman’s infibulation scar may be cut and resewn many times during her reproductive years. In addition, the amputation of the clitoris and other sensitive tissue reduces a woman’s ability to experience sexual pleasure. Despite the fact that FGM causes pain and suffering to millions of women and girls and can be life-threatening, it remains deeply entrenched in certain social value systems.

It is important to understand that no social problem is isolated. It exists in harmonium with the elements in ecology. Efforts to eliminate female genital mutilation have often been unsuccessful because opponents of the practice ignored its social and economic context. In societies where people cannot read or write, what is the point of telling them about infection and hemorrhage? We cannot fight the practice just by invoking the health risks or legal arguments. We have to adopt a cultural approach to addressing this barbaric tradition. Empowerment and awareness have to start from an individual and extend to the society as a whole. Also patriarchal authority and control of female sexuality and fertility in these societies is highly prevalent. Hence, designing prevention strategies to involve men have utmost importance. Religious leaders can play an important role in eliminating the misconceptions held by the public. It is critical to clarify that no religion encourages and accepts FGM. Political commitment is important too. Unless the government is committed, it will not be possible to enforce the law and to penalize those who perform the procedure. Changing this reality to bring about positive and protective social behavior requires a holistic and integrated approach. There is no clear enemy in this war against FGM. But all this time, I just had one thought in my head. In spite of all the social pressure and opposition, why would any women/mother, want to circumcise her daughter?

To schedule an interview with GWMCHstudents contact director of communications Rachel Perrone at rachel@rhrealitycheck.org.

gwmchstudents

I agree with your solution to stop such practices. Adopting a cultural approach seems to be the best solution. I also agree with the idea of involving men and religious leaders. Great topic!

Tae

gwmchstudents

Priya,

This issue should be at the top of the reproductive health rights agenda for all the reasons cited in this blog. However, I beleive it is a very trival issue to tackle because as you stated it is not only strangers committing this act but mothers and fathers who bring their daughters for such a ceromony. I do believe that addressing the issue by engaging fathers and religious leaders.

L. Williams

gwmchstudents

Tae & Lanita,

Thank you both for your thoughful comments. Yes, I do think involving men and religious leaders is the most appropriate method to work towards eliminating this social evil. But the sad part is the limited resources available to train and educate these men to speak up against such a practice. During my research for the blog, I found several instances of highly trained physicians and healthcare professionals supporting FGM using baseless health benefits. If healthcare professionals fail to bring out the harm associated with the practice, how can we expect common ‘MAN’ to understand the severity of the consequences ? The journey just started with some countries (Egypt) banning the practice, but there is a long way to go.

Priya

gwmchstudents

Vishnu,

Great topic. The solutions you pose, addressing the societal factors, will hopefully not only end this barbaric practice but address other disadvantages women in these countries face.

In addition to religious leaders, community leaders and other important persons should also be addressed.

Kristina

gwmchstudents

Priya,

Excellent topic. FGM is a practice that requires a multifaceted approach to debunk myths and end this gruesome practice.

In order to have a sustainable interventions to end this practice there will be a need for both the community and physicians to act as a driving force.